title: Does prolonged anti-inflammatory therapy reduce number of unnecessary repeat saturation prostate biopsy?
abstract: BACKGROUND
  The effect of a prolonged oral anti-inflammatory therapy on PSA values in patients with persistent abnormal PSA values after negative prostate biopsy (PBx) was evaluated.
  
  
  METHODS
  From September 2011 to September 2012, 70 patients (medi- an age 62 years), with persistent abnormal PSA values after negative extended PBx, were given an herbal extract with anti-inflammatory activity for 3 months (Lenidase®; 1 tablet daily constituted of baicalina, bromelina and escina). All patients were submitted to prostate biopsy for: abnormal DRE; PSA > 10 ng/mL, PSA values between 4.1-10 or 2.6-4 ng/mL with free/total PSA < 25% and < 20%, respectively. Three months after the end of anti-inflammato- ry therapy all patients were revaluated; indication for repeat saturation biopsy (SPBx) and detection rate for PCa were compared with those previously recorded in our Department using the same inclusions criteria for biopsy.
  
  
  RESULTS
  Oral administration of Lenidase® was well tolerated and no side effects were observed; PSA values decreased in 54 (77.8%) out 70 patients with a median PSA reduction of 20.5% (from 8.8 to 7 ng/mL) and remained unchanged in 16 patients (22.2%); the repeat SPBx rate resulted significantly lower (22.8% vs 35.5%; p < 0.05) showing a superimposable detection rate for PCa (3 cases) in comparison with our previous data (18.7% vs 22%).
  
  
  CONCLUSIONS
  In our preliminary data a prolonged oral anti-inflammatory therapy reduced PSA levels in patients with negative PBx and persistent suspicious for PCa decreasing the indication to perform repeat SPBx (about 30% of the cases).
authors.affiliation: Urology Unit - Cannizzaro Hospital, Catania, Italy. piepepe@hotmail.com
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Candiano
authors.forename: Pietro
authors.initials: P
authors.lastname: Pepe
authors.forename: Francesco
authors.initials: F
authors.lastname: Pietropaolo
authors.forename: Francesco
authors.initials: F
authors.lastname: Aragona
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D000284:Administration, Oral; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001706:Biopsy / Q000706:statistics & numerical data*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy; D028321:Plant Preparations / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D011472:Prostatitis / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D012720:Severity of Illness Index; D019564:Unnecessary Procedures
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; C583151:Lenidase; D028321:Plant Preparations; D017430:Prostate-Specific Antigen